Organization
CENTER FOR BEHAVIORAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAY VANDENBOGAARD (OWNER/PRIMARY THERAPIST)
(541) 704-0762
Entity
Organization
Contact information
Practice address
2225 PACIFIC BLVD SE, SUITE 207, ALBANY, OR 97321-7907
(541) 704-0762
(541) 704-0070
Mailing address
2225 PACIFIC BLVD SE, SUITE 207, ALBANY, OR 97321-7907
(541) 704-0762
(541) 704-0070
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
064
OR
251S00000X
Community/Behavioral Health Agency
Primary
064
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500625423
—
OR
Enumeration date
12/16/2010
Last updated
12/16/2010
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